Breastfeeding Initiation and Continuation Among Sexual Minority Women.

OBJECTIVES: Identify disparities in breastfeeding initiation and continuation among sexual minority women (SMW) and determine if known risk factors explain any observed disparities. METHODS: We used data from the 2006 to 2017 National Survey of Family Growth female pregnancy questionnaire. We measured sexual orientation using self-reported sexual identity and histories of same-sex sexual experiences reported by women (heterosexual-WSM [women who only reported sex with men]; heterosexual-WSW [women who reported sex with women]; bisexual, and lesbian. In total, we had 18,696 births that occurred within the last 10 years and used logistic and multinomial regression models to assess sexual orientation disparities in breastfeeding initiation and duration that clustered on women to account for potential multiple births to a woman. RESULTS: Compared to heterosexual-WSM, infants born to lesbian-identified women had decreased odds of ever being breastfed (OR 0.55, 95% CI 0.30, 0.99) and a decreased relative risk of being breastfed more than 6 months (RRR 0.46, 95% CI 0.22, 0.97). Infants of heterosexual-WSW had an increased odds of ever breastfeeding (OR 1.40, 95% CI 1.12, 1.74) and increased relative risk of breastfeeding more than 6 months (RRR 1.32, 95% CI 1.02, 1.69). CONCLUSIONS: Our results show that infants born to lesbian-identified women were less likely to be breastfed than those born to their heterosexual counterparts, even after adjusting for several factors associated with breastfeeding behaviors. We found no differences in breastfeeding between bisexual women and heterosexual-WSM. Understanding and addressing the barriers sexual minority women face for breastfeeding is critical for ensuring maternal and child health equity.

Graduated driver licensing provisions: an analysis of state policies and what works.

OBJECTIVE: To compare and contrast how specific graduated driver licensing (GDL) components have been implemented in different states and explore how the policies currently in place have affected state-level teen crash and mortality outcomes. METHODS: The study design involved a policy analysis using methodology set forth by Teitelbaum and Wilensky (2007). Eight states were selected, 2 each from 4 different regions in the United States. Each pair of states was similar in terms of geography and vehicle miles driven per capita but differed in the relative strength of their GDL legislation. Teen fatality and crash rates in 2010 as well as specific GDL components were the variables used for analysis. A weighted decision matrix was created to reflect the comparative impact of each variable. RESULTS: In every region, the state with the stronger GDL policy scored higher on the decision matrix than the state with the weaker GDL policy. The Eastern states (Maryland and Vermont) scored the best overall (123.9); the Southern states (Mississippi and Georgia) scored the poorest overall (-55.7). CONCLUSIONS: Consistent with other GDL research, states with stronger GDL policies had more favorable teen crash and mortality outcomes than states with weaker ones. Analysis showed that the policies in strong states shared several common themes: more required practice hours, ban on all teen passengers, and night driving restrictions for 12+ months. Implications for state policy makers are provided.

C U L8ter: YouTube distracted driving PSAs use of behavior change theory.

OBJECTIVE: To examine the inclusion of health behavior theory in distracted driving PSAs on YouTube.com. METHODS: Two-hundred fifty PSAs were assessed using constructs from 4 prominent health behavior theories. A total theory score was calculated for each video. Multiple regression analysis was used to identify factors associated with higher theory scores. RESULTS: PSAs were generally lacking in theoretical content. Video length, use of rates/statistics, driving scenario depiction, and presence of a celebrity were positively associated with theory inclusion. CONCLUSION: Collaboration between health experts and PSA creators could be fostered to produce more theory-based distracted driving videos on YouTube.com.